Individual
MELISSA OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT-IT
Contact information
Practice address
165 W NETHERWOOD ST STE A, OREGON, WI 53575-1107
(608) 835-5050
(608) 835-5050
Mailing address
165 W NETHERWOOD ST STE A, OREGON, WI 53575-1107
(608) 835-5050
(608) 835-5010
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
582-228
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582-228
STATE LICENSE
WI
Enumeration date
11/21/2017
Last updated
11/21/2017
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